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Volume 1, No. 73, August 5, 2020

ADEA Advocacy in Action
This appears weekly in the ADEA Advocate to summarize and provide direct links to recent advocacy actions taken by ADEA. Please let us know what you think and how we might improve its usefulness.
 
Lost Clinic Revenue—Provider Relief Fund
May 1 – Joint letter [ [link removed] ] with the Partnership for Medicaid on fund reimbursement for Medicaid providers.
 
Other COVID Issues
July 29 – Joint letter [ [link removed] ] regarding Borrower Relief extension
July 22 – Joint letter [ [link removed] ] regarding CARES Act implementation
July 10 – Joint letter [ [link removed] ] to Sec. Wolf Regarding the Student and Exchange Visitor Program
July 2 – Joint letter [ [link removed] ] to Dept. of State and DHS Regarding Guidance for International Students.
 
Dental School COVID Related Capital Needs
July 2 – Joint letter [ [link removed] ] to HELP Committee Regarding Reopening Costs.
June 1 – ADEA letter [ [link removed] ] to Sen. Lamar Alexander regarding reopening guidelines.
 
State Advocacy
July 20 – ADEA webinar [ [link removed] ] on State Advocacy
 
For a full list of ADEA Letters and Policy Memos, click here [ [link removed] ] .

HHS Extends Provider Relief Fund Deadline for Medicaid, CHIP and Dental Providers
 
On July 31, the Department of Health and Human Services announced [ [link removed] ] that it was extending the period wherein eligible Medicaid, Medicaid managed care, Children’s Health Insurance Program (CHIP) and dental providers could begin applying for funding of up to two percent of reported revenue from patient care through Aug. 28. The goal for this opportunity was to reach the remaining providers participating in state Medicaid and CHIP programs that did not receive funding.
 
While this extension is welcomed, it does not solve the problem that dental schools are having by being deemed ineligible for reimbursement of lost Medicaid revenue under the Provider Relief Fund (PRF). Since ADEA first raised this matter in March, we have heard from several institutions. We believe that the problem lies in the fact that the academic medical centers, which would likely have received an allocation in the initial Medicare tranche of payments from PRF, share tax identification numbers with the dental schools where they exist at the same institutions.
 
Most recently, ADEA communicated to HHS Secretary Alex Azar on July 27 about this continuing problem and requested a meeting to resolve it. On July 30, the Secretary’s office responded to ADEA that the information was being placed into the hands of those who can resolve it. We will continue communicating with them and keep you informed of the result.

HHS Extends Public Health Emergency Declaration
 
On July 23, the Department of Health and Human Services Secretary Alex Azar extended the public health emergency declaration [ [link removed] ] for an additional 90 days. The extension provides the government with certain flexibilities and authorities [ [link removed] ] , such as:
 • Expanding the use of telemedicine,
 • Using funds appropriated to the Public Health Emergency Fund to immediately respond to the public health emergency, and
 • Extending limit liability of volunteer health care professionals during the public health emergency to the laws of the state to which the professional has been deployed to respond to the public health emergency and in which care is provided.

The declaration, initially signed in January 2020 [ [link removed] ] , was first extended in April [ [link removed] ] until July. The most recent extension is the third extension of the original public health emergency declaration.

Trump Administration Issues Interim DACA Policy
 
The Trump administration issued a memo [ [link removed] ] on new Deferred Action for Childhood Arrivals (DACA) rules effective immediately. The memo, among other things:
 • Rescinds previous DACA policy memos,
 • Instructs the Department of Homeland Security (DHS) to reject all new initial DACA applicants,
 • Limits renewals of current DACA recipients to one year as opposed to two years and
 • Provides an exception to their new policy, noting that nothing in the memo precludes it from granting a new initial deferred action applicant on a case-by-case basis, if warranted.

The memo goes on to explain the Department’s rationale for its current interim changes to the program. Specifically, it explains the Department’s basis for rejecting new initial applicants to the program is that, unlike current DACA recipients, the new initial applicants have no reliance on the program and, as such, the DHS is within its right to reject applicants as it reviews the validity of the program. Likewise, the DHS asserts that limiting renewals to one year for current DACA recipients does not adversely impact the DACA recipients or third parties who benefit from their presence. DACA recipients are still able to structure their affairs based on their one-year renewal, and those benefiting from the presence of DACA recipients will continue to benefit from their presence as long as their applications are renewed yearly.
 
The DHS memo further states that in light of the Supreme Court’s decision in the Department of Homeland Security v. Regents of the University of California [ [link removed] ] , the agency is taking these actions in the interim while it reviews the DACA program as part of a “full and careful consideration of full rescission” of the program.
 
In June, the Supreme Court ruled in favor of the Regents of the University of California in the lawsuit, also known as the “DACA case.” The DACA program grants work permits and deferral from deportation to nearly 700,000 undocumented immigrants who arrived in the country as children. The status lasts for two years and is renewable, but it does not provide a path to citizenship.
 
The Court ruled that DHS did not comply with procedural requirements and that it did not provide a reasonable explanation for ending the program. It is important to note that in the ruling, the Court stated that the administration may try again to provide a reasonable explanation for shutting down the program. This new memo represents renewed efforts by the Trump administration to end the DACA program per the Court’s instructions.
 
The interim changes to the program are likely to result in further litigation, as some believe that it is counter to the Supreme Court’s intent.

New Hampshire Governor Vetoes Adult Dental Medicaid Benefits Over Financial Concerns
 
Regular readers of the ADEA Advocate may recall [ [link removed] ] that the New Hampshire General Court passed a bill [ [link removed] ] in June that would have established contracts with a dental managed-care organization to provide dental care to people over the age of 21. On July 29, however, Gov. Chris Sununu (R) vetoed the bill. In his veto message [ [link removed] ] , the Governor stated that while he supported the “concept of adding an adult dental benefit,” he could not support adding $11 million to the state’s budget while the state is facing revenue shortfalls. He also expressed hope that the state’s Department of Health and Human Services would be able to develop and implement an affordable benefit as it was instructed to do under HB 4 [ [link removed] ] , which was signed in September 2019.

Online Tool Shows How States Are Spending Coronavirus Relief Funds
 
Included among the billions of dollars sent to states through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act were $150 billion of Coronavirus Relief Funds [ [link removed] ] (CRFs). These funds were meant to cover necessary expenditures incurred starting March 1 or later that were due to COVID-19 public health emergencies, and that were not accounted for in a state’s most recently approved budget. The CARES Act, which was signed in March, sent at least $1.25 billion in CRFs to every state, and states have elected to spend these funds in a variety of ways.
 
The National Conference of State Legislatures [ [link removed] ] has developed a tool to help monitor how states have spent those funds. States like Iowa [ [link removed] ] have elected to use those funds to address health care issues, using $50 million to offer relief to health care providers and another $85 million to expanded telehealth and telework. Other states like Wisconsin [ [link removed] ] have used the funds for issues faced by institutions of higher education, sending $37 million to institutions to reimburse necessary, unbudgeted expenditures made in response to the COVID-19 pandemic.

Alabama to Test All Returning College Students for Coronavirus
 
On July 24, the state of Alabama [ [link removed] ] unveiled plans to test more than 200,000 students for COVID-19 before they return to college campuses in the fall. The program uses funds from the federal Coronavirus Aid, Relief, and Economic Security Act to provide free tests for students in the state. Many schools in the state will also require students to produce a negative test before they can be permitted to return to campuses.
 
The program has established 13 testing sites across Alabama, and students living in-state will be responsible for scheduling an appointment after receiving an email at their school account. Out-of-state students will be sent mail-in test kits. Tests will need to be completed at least three days before returning to campus, but no longer than 14 days.

ADEA State Calendar [ [link removed] ]

ADEA Washington Calendar [ [link removed] ]

ADEA U.S. Interactive Legislative and Regulatory Tracking Map [ [link removed] ]

Key Federal Issues [ [link removed] ]

Key State Issues [ [link removed] ]

The ADEA Advocate [ [link removed] ] is published weekly. Its purpose is to keep ADEA members abreast of federal and state issues and events of interest to the academic dentistry and the dental and research communities.
 
©2020
American Dental Education Association
655 K Street, NW, Suite 800
Washington, DC 20001
202-289-7201, adea.org [ [link removed] ]

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B. Timothy Leeth, CPA
ADEA Chief Advocacy Officer
 
Bridgette DeHart, J.D.
ADEA Director of Federal Relations and Advocacy
 
Phillip Mauller, M.P.S.
ADEA Director of State Relations and Advocacy
 
Brian Robinson
ADEA Program Manager for Advocacy and Government Relations
 
[email protected] [ mailto:[email protected]?subject=State%20Update%3A%20 ]

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